I am in a good position to report from the NHS frontline, having been in hospital with pneumonia for just over a week from 28 December.
I was admitted following an early evening visit from a district nurse to the home I share with my younger daughter, her husband and their three children. The nurse rang A&E to advise them of my impending arrival but warned us that there was a four-hour wait for an ambulance. My daughter therefore decided to drive me in, and we arrived at a packed casualty unit. I was desperate for oxygen and my daughter begged at the reception desk for me to be triaged to access some, with no success. At 11.30 p.m. I was finally examined and hooked up to an oxygen supply.
I was found a bed in the admissions ward at 4 a.m., in an atmosphere reminiscent of a war zone. We were a mixed bunch: a minxy starlet type who had overdosed and whose miserable-looking geezer boyfriend slept in a chair by her bedside until she was discharged; a person in a pink nightie with a deep bass voice, identifying as female; an elderly case of self-neglect who had to be cut out of her underwear, nits removed from her nether regions by two kind and sympathetic nurses; a woman who went for a scan and was then moved to the operations ward. Patients came and went at lightning speed, often in the night. The place was not clean.
The shared loo was set (as were all the others in this ten-year-old hospital) lower off the ground than is convenient for us oldies. Brushing one’s teeth inches away from a shared toilet (used also by the overdose boyfriend) is a third-world experience that I do not wish to repeat. Using the shower at the end of a corridor was frowned upon, hardly surprising since it had no grab handles and required a hard-pressed member of staff to escort you there.
A well-meaning nurse, reaching over for a switch behind the chair next to my bed, dislodged my heavy NHS walking stick another member of staff had thoughtfully propped up, hitting me smartly on the head as it fell. I burst into tears.
After three nights in this hellhole, I was moved to a single room in a ‘frail’ ward, a great advance. The nurses who moved me there late at night (it was all a bit reminiscent of the infamous ‘House on the Embankment’ in Moscow for night removals) had to guess the setting on my oxygen supply. They chose 12 instead of two, which meant ear-splitting levels of oxygen for what remained of the night.
This room had its own ensuite shower. On the first day, I noticed that the basin in my room was slow to drain. I mentioned it to a nurse who said: ‘Oh, they’re all like that.’ When I had a shower, it didn’t drain either, resulting in a massive flood. A plumber came a couple of days later, but it turned out he was just checking the taps because they were ‘little used’.
‘There’s nothing wrong with the taps, it’s the drains that need to be looked at,’ I said. ‘That’s not what I’m here for,’ returned the plumber. ‘I need a docket. You need to report it.’ ‘I have reported it’ — and so the Kafkaesque dialogue continued, reminding me of the worst days of the 1970s.
The light in the ensuite of my single room was theoretically operated via a movement sensor but, during the first night, the door to the bathroom swung open and a bright light woke me when I had just got to sleep. It did so three more times. Eventually, I learned to wedge the door shut last thing to save being woken up by the sudden, brilliant illumination. The light also went off at unexpected moments, leaving one in the pitch dark halfway through a shower or sitting on the loo. What price health and safety?
After three nights in a single room, the door burst open one evening at seven and two bad-tempered nurses said: ‘We’re moving you. Is that all right?’ ‘Do I have any choice?’ ‘No.’ As they propelled me along to a new ward at breakneck speed, one said: ‘You’ll enjoy the craic!’ I soon discovered every other patient in my new ward was suffering from senile dementia.
Two-and-a-half hours later, a routine check on my blood oxygen levels revealed that they had omitted to hook me up to the oxygen supply, and I was at risk of imminent organ failure.
A nursing assistant on the night shift was tearful one morning, after a catalogue of difficulties dealing with elderly dementia patients, one of whom had just removed her cannula (the device allowing intravenous administration of drugs or saline). The night sister was also close to tears, running a temperature.
A saving grace in this pretty depressing catalogue of shortcomings was the student nurse. A kind, quick, cuddly girl, not yet worn down by the drudgery of the job, she did not stand on demarcation lines as some do. (‘No, dear, we don’t do teas.’) She obliged me one morning by bringing me a plastic cup of hot water to put my quarter of lemon in, a reminder of home. Breakfast wasn’t until 9.30 a.m., and the first hot drink of the day not until after that, so one’s tongue was hanging out by then.
What do I make of it all, now that I am back home (on yet another course of antibiotics and a permanent oxygen supply)? The district nurse who sent me to hospital arrived to see me without the faintest idea of my medical history. How can that be justified, in this age of the instant download? My GP says the computer system meant to make patient history available online was found not to be fit for purpose.
The physical state of the hospital building was a disgrace. The staff are dispirited and need robust hands-on leadership of the Hattie Jacques type to keep them on the ball and responsive to patients.
What is to be done about the growing army of poor confused souls who ramble on, or occasional emit piercing cries, like those in the last ward I was in? Once cured of their infections, they go back out into the world, some to family care, others to their old people’s home, a haunting raggle-taggle of the bewildered, going nowhere on their zimmer frames.